I Need Help With Distress, Trauma, or Caregiver Strain for a Veteran
Serious illness and dying can bring back experiences that have been quiet for years.
Caregivers may also be carrying more than they can sustain.
If someone is in immediate danger, call 911. For suicidal thoughts or a mental health crisis involving a Veteran or service member, call 988 and press 1, or text 838255. You can contact the Veterans Crisis Line because you’re worried about someone else.
Tell the Care Team What You’re Seeing
You don’t have to know whether it’s PTSD or something else.
Describe what’s happening and let the team sort it out.
Past trauma or military experiences may affect trust, sleep, touch, privacy, fear, and how the Veteran responds to care.
Ask them to consider medical causes too.
Pain, breathing problems, delirium, infection, medication effects, sleep loss, or progression of the illness can all look like emotional distress.
Don’t assume agitation, fear, or confusion has one cause.
It may have more than one.
If You Can’t Keep Doing This Safely
If you’re exhausted, angry, frightened, not sleeping, getting sick, or worried you can’t keep the Veteran safe, say it plainly. If you’re worried you might hurt the Veteran or yourself, or lose control, say that directly. Call 988 and press 1. If someone is in danger right now, call 911.
Ask your hospice team, VA social worker, or VA Caregiver Support Team:
- What can someone else take over?
- What happens if I can’t continue tonight?
- Is another care setting needed?
A plan that depends on one exhausted person with no backup isn’t a plan.
Tell Them What Makes Care Harder
If the Veteran is willing, tell the team what makes care more distressing.
That may include:
- unexpected touch
- loud noises
- being restrained or unable to leave
- loss of privacy
- certain procedures
- being cared for by someone of a particular gender
- darkness or being woken suddenly
Ask what staff should know before touching or moving them.
“Please tell us before touching or moving them. Unexpected touch makes them more distressed.”
The goal isn’t to make the Veteran retell what happened.
It’s to make care less distressing now.
When the Veteran Is Afraid, Angry, or Withdrawn
Fear, anger, silence, or pulling away may be illness, trauma, grief, loss of control, or more than one of these.
Don’t force a conversation about military experience.
Ask:
“What’s making this hardest right now?”
Notice what happens just before the distress and whether pain or another symptom is getting worse.
If alcohol or other substance use is affecting safety, medications, or care, tell the clinical team.
Spiritual or Moral Distress
Some Veterans struggle near the end with guilt, forgiveness, meaning, faith, or what they did, saw, or couldn’t prevent.
Ask what the Veteran wants.
That may be prayer or ritual, a chaplain, someone comfortable talking about guilt or moral injury, help contacting someone, reconciliation, time alone, or no religious involvement at all.
Spiritual care follows the Veteran’s beliefs, not someone else’s idea of what they need.
Who to Ask
- Hospice or palliative care team: fear, agitation, trauma, spiritual distress, symptom changes, and what to do after hours
- VA mental health team or Vet Center: mental health support, trauma-related distress, or substance use affecting care
- VA Caregiver Support Team: caregiver strain, respite, coaching, and building a backup plan
Ask whether the hospice or palliative team has experience caring for Veterans near the end of life.
A team can still provide good care without Veteran-specific training. Added expertise may help when military experience is affecting care.
Before You Rely on the Plan
Make sure:
- medical causes of new distress have been considered
- the care team knows about important triggers
- the Veteran isn’t being pressured to discuss what they don’t want to discuss
- someone knows who to call after hours
- the caregiver has a backup
Helpful Resources
Free, confidential, 24/7. Call 988 and press 1, or text 838255. The Veteran doesn’t have to be enrolled in VA. You can call because you’re worried about someone else.
Around-the-clock, confidential support for Veterans, service members, and their families, with help connecting to a local Vet Center when eligible. Call 1-877-927-8387.
Caregiver coaching, respite, peer support, and help building a backup plan. Call 1-855-260-3274.